Communications and Mass Media

Mass Media for Public Health
(Funded by the National Institute for Health Research)

Media advertising campaigns are used to promote sales of products, but they can also be used to give the public information about health and to encourage them to be more healthy (eg. adverts encouraging people to stop smoking, or to drink sensibly, or to use condoms).  In recent years, we have seen a growth in new types of advertising and media, particularly on the internet and mobile phones.  The evidence base on these newer types of media campaign is still emerging.

This systematic review-based study will attempt to pull together all the evidence on media advertising campaigns about health, to provide clear answers to the questions:

  • How effective are mass media advertising campaigns at changing health behaviours?
  • Are they more effective with certain groups of people than others?
  • Are they equally effective at local, regional and national level?

By effective, we mean in the first instance ‘do they encourage the changes in behaviour which they are trying to change?’.  However, sometimes campaigns do not try to change behaviour, but to move people towards being able to change behaviour in the future, for example by encouraging them to think differently about a health issue, or to feel more confident in their ability to change.  We are interested in all of these types of effects.

We will focus on mass media campaigns for alcohol use, illicit drug use, diet, physical activity, sexual and reproductive health, and smoking cessation and prevention.  By media, we mean campaigns which use television and radio advertising, cinema advertising, advertising in newspapers and magazines, advertising on billboards and other types of outdoor advertising (eg. bus shelters, taxi cabs), advertising on the internet and on mobile phones, and other types of advertising (eg. advertising in video games).

The study will involve wide consultation with public health practitioners and commissioners at national and local level, and with representatives of public involvement groups.

ISM Staff: Linda Bauld, Martine Stead, Kathryn Angus and Fiona Dobbie

External collaborators: Sarah Lewis and Tessa Langley, University of Nottingham; James Thomas and Kate Hinds, University of London, EPPI; Shona Hilton and Srinivasa Katikireddi, University of Glasgow

Scoping and Prioritisation of Health Communication Research and Country Capacity Building Activities
(Commissioned by the World Health Communication Associates)

The purpose of this project is to scope research priorities for communicable disease communication capacity building. The project includes defining priorities and opportunities for research evidence to support development of better practice, mapping research capacity,  and the identification of strategy options to progress the development of evidence-based good practice.

ISM Staff: Georgina Cairns, Marisa de Andrade and Kathryn Angus

The Marketing of Electronic Cigarettes in the UK: Direct and Indirect Promotion through Traditional, Digital and Social Media
(Funded by Cancer Research UK)

This project analysed how electronic cigarettes (e-cigarettes) are being marketed in UK newspapers and magazines; retail trade press; tobacco journals; company press releases; through television clips and other traditional communication channels and sources. It also investigated marketing on online social network sites.

ISM Staff: Marisa de Andrade, Gerard Hastings, Kathryn Angus, Richard Purves and Diane Dixon

de Andrade M, Hastings G and Angus K (2013). Promotion of electronic cigarettes: Tobacco marketing reinvented? British Medical Journal, 347: f7473. doi:10.1136/bmj.f7473.

de Andrade M, Hastings G, Angus K, Purves R and Dixon D (2013). The Marketing of Electronic Cigarettes in the UK. Commissioned by Cancer Research UK. Stirling: Institute for Social Marketing, November. Report

Something to Declare? Gathering Perceptions of Illicit Tobacco Through Radio
(Funded by NHS Greater Glasgow & Clyde)

This project uses innovative methods to explore how illicit tobacco is viewed by deprived communities in Scotland. Unlike the usual survey or interview-based approach, the NHS Greater Glasgow & Clyde (GGC) funded study enables participation via workshops on radio production and broadcasting skills. Whilst engaged in this training, participants are encouraged to discuss their perceptions of illicit tobacco and prepare radio programmes. Guided by an assets based approach, it empowers participants by teaching essential skills to improve employability and encourage creativity in communities. Findings will be used to inform the development of a social marketing campaign across the NHS Greater Glasgow & Clyde area.

ISM Staff: Marisa de Andrade

Addictions and Lifestyles in Contemporary Europe - Reframing Addictions Project (ALICE RAP)
(2011 - 2016)
(Funded by the European Commission)

ALICE RAP aims to study and analyse the development and place of well-acknowledged and new addictions as a major societal trend in Europe in relation to governance and public policies and responses. The study involves 67 research institutions from 25 European countries covering the humanities, social sciences and biological and medical sciences. Its scientific objectives are:

  1. To describe the ownership of addictions through an historical study of addiction over the ages, an analysis of public and private stakeholder views and through image analyses, of professional and citizenship views.
  2. To study how addictions are classified and defined, followed by estimates of their health, social and economic impact.
  3. To investigate determinants of addiction through a coordinated and cohesive social, economic and biological analysis of initiation, transition into problem use and transition into and out of dependence.
  4. To analyze the business of addiction through studies of revenues, profits and participants in legal and illegal trade, the impact of suppliers on addictive substance use and behaviours, and analyses of webs of influence on policy responses.
  5. To study addictions governance by describing the views and forces that determine the ways societies steer themselves and by stock taking of present governance practices to old and emerging addictions.
  6. To analyze youth as customers through considering the impacts of new technologies on promoting and mitigating use, by studying the interrelations of culture and biology, and by determining features that promote resilience and nudge young people to reduce problematic use.

ISM is contributing specifically to Objectives 1 and 4.

ISM Staff:
Martine Stead, Kathryn Angus, Richard Purves, Gerard Hastings, Anne Marie MacKintosh and Crawford Moodie

Health Communications for Communicable Disease
(Commissioned by the European Centre for Disease Control and in collaboration with the National University of Ireland, Galway)

ISM is working with universities in the Republic of Ireland and Spain to research effective communication approaches and strategies for the prevention and mitigation of communicable disease transmission and impact on health. The research is intended to support the establishment of a programme for dissemination of evidence based health communication activities and innovations on communicable diseases for country support in the EU and EEA/EFTA 2009-12

The project involves a survey-based mapping and evaluating information on the status of implementation of health communication activities in Europe, a qualitative needs assessment of European practitioners with responsibility for health communications to formulate and deliver health communications, literature reviews of good practice, systematic literature reviews of the evidence for effectiveness and synthesis reports of evidence-based practice critical success factors.

ISM Staff: Georgina Cairns, Laura Macdonald, Kathryn Angus and Gerard Hastings


Macdonald L, Cairns G, Angus K and de Andrade M (2013). Promotional communications for influenza vaccination: A systematic review. Journal of Health Communication, 18(12): 1523-1549. doi:10.1080/10810730.2013.840697 eprint

Cairns G, de Andrade M and Macdonald L (2013). Reputation, relationships, risk communication, and the role of trust in the prevention and control of communicable disease: A review Journal of Health Communication, 18(12): 1550-1565. doi:10.1080/10810730.2013.840696


  • Behaviour Change Theories Systematic Review - Angus K, Cairns G, Purves R, Bryce S, Macdonald L, Gordon R (2013). Systematic literature review to examine the evidence for the effectiveness of interventions that use theories and models of behaviour change: towards the prevention and control of communicable diseases. Stockholm: ECDC.
  • Social Marketing Evidence Review - Macdonald L, Cairns G, Angus K and Stead M (2012). Evidence review: Social marketing for the prevention and control of communicable disease. Stockholm: ECDC.
  • Immunisations Systematic Review - Cairns G, Macdonald L, Angus K, Walker L, Cairns-Haylor T and Bowdler T (2012). Systematic literature review of the evidence for effective national immunisation schedule promotional communications. Stockholm: ECDC.
  • Status of health communication activities in Europe - Doyle P, Sixsmith J, Barry MM, Mahmood S, Macdonald L, O’Sullivan M, Oroviogoichoechea C, Cairns G, Guillen-Grima F and Núñez-Córdoba J (2012). Public health stakeholders’ perceived status of health communication activities for the prevention and control of communicable diseases across the EU and EEA/EFTA countries. Stockholm: ECDC.
  • Trust and Reputation Management Literature Review - European Centre for Disease Prevention and Control (2011). A literature review of trust and reputation management in communicable disease public health. Stockholm: ECDC.

SunSmart: Qualitative Research to Guide the Conceptual Development of SunSmart
(2005) (Commissioned by Cancer Research UK)

Sunsmart is a national skin cancer prevention awareness raising campaign developed by Cancer Research UK with support from the UK health departments. This qualitative study was conducted to guide the creative decision-making for the youth and adult campaigns in Summer 2005. Both campaigns formed part of the SunSmart 5-year strategy and were designed to promote the SunSmart code using a variety of media, including electronic and print. The fieldwork, which employed focus group techniques, was conducted in two stages and was integral to the campaign's creative development process.

ISM Staff: Douglas Eadie

Eadie D and MacAskill S (2007). Results from an exploratory study of sun protection practice: Implications for the design of health promotion messages. Health Education, 107(3): 250-260.

Evaluation of Dementia Awareness Week
(Commissioned by Alzheimer Scotland)

Alzheimer Scotland was keen to evaluate the effectiveness of their Dementia Awareness Week and other awareness raising activities. The Awareness Week 2003 aimed to counteract ignorance, misunderstanding and stigma surrounding the illness, largely through mass media communications via newspapers, radio and posters. The awareness raising activities are supported by the Scottish Executive linking to their campaigns to challenge stigma and discrimination around mental ill-health in Scotland. The main objective of the 2003 Awareness Week was to encourage more people who display signs of dementia to present earlier to medical specialists.

This study sought to qualitatively evaluate consumer response among the general public in areas where there was high intensity media activity, namely Dundee and Dumfries. It examined response to the Awareness Week campaign materials and communication routes and explored public knowledge and attitudes in relation to dementia and early presentation for diagnosis. The findings, which revealed negative perceptions of Alzheimer's among the general public and considerable knowledge gaps about earlier stages, were used to inform the following year's campaign.

A similar evaluation was conducted of the 2004 Awareness Raising campaign, which focussed on the Scottish Awareness Week in May and World Alzheimer's Day in September 2004. Qualitative research was undertaken with the general public, people with dementia and carers.

ISM Staff: Susan MacAskill, Elinor Devlin (left 2005), Douglas Eadie and Susan Anderson (left 2005)

Devlin E, MacAskill S and Stead M (2007). ‘We’re still the same people’: developing a mass media campaign to raise awareness and challenge the stigma of dementia. International Journal of Nonprofit and Voluntary Sector Marketing, 12(1): 47-58.

SunSmart: Qualitative Research to Investigate Attitudes to the Sun, Sun Protection and Skin Cancer with Parents and Young People
(Commissioned by Cancer Research UK)

SunSmart is a national skin cancer prevention awareness raising campaign developed by Cancer Research UK with support from the Department of Health. This qualitative study was conducted during the campaign's formative phase to provide insights into how key target audiences receive, process and utilise sun protection messages. It explored attitudes and behaviour in relation to sun, sun protection and skin cancer, together with response to sun protection messages and materials, among key target groups of teens, young adults and mothers of young children. The findings have been instrumental in informing the SunSmart 2004 campaign, Kids Cook Quick, and in guiding the national SunSmart 5-year strategy. A summary of the findings can be accessed on the SunSmart web-link below.

ISM Staff: Douglas Eadie and Susan MacAskill 

Exploratory Study to Evaluate Young People's Response to Mass Media Tobacco Prevention
(Funded by Cancer Research UK)

Smoking prevalence increases rapidly with age. Research has indicated that while only 1% of 11 year olds smoke regularly, over a fifth (21%) of 15 year olds are regular smokers. Targeting young people before smoking initiation in their early teens is critical to reducing smoking rates. Mass media campaigns can play an important role in reaching large numbers of young people directly with prevention messages. Given the current level of debate in this area regarding whether youth prevention is worthwhile and which message theme(s) are most appropriate, this study was conducted to explore young people's views, attitudes and behaviours towards smoking and examine young people's response to different types of message appeals, including normative/denormalisation messages, industry manipulation messages, and information/fear-based messages.

A qualitative research design was employed. A total of 12 focus groups and 18 friendship pairs were conducted in England with 11-14 year olds, half of whom were smoking and half of whom were experimenting with smoking.

ISM Staff: Elinor Devlin (left 2005), Douglas Eadie, Martine Stead and Gerard Hastings

Devlin E, Eadie D, Stead M and Evans K (2007). Comparative study of young people’s response to anti-smoking messages. International Journal of Advertising, 26(1): 99-128.

Devlin E, Eadie DR, Stead M and Hastings GB (2004). Applying marketing communication principles to a mass media youth smoking prevention campaign. Presentation at the European Marketing Academy Conference, Murcia, Spain, 18th-21st May.

Devlin E, Stead M, Hughes K and Eadie DR (2004). Informing a charity mass media campaign using a social marketing framework: the case of youth smoking prevention. Presentation at the 4th International Colloquium on Non-profit, Social and Arts Marketing, London, 15th September.

Devlin E, Hughes K, Eadie DR and Stead M (2004). Youth smoking prevention in the UK: the way forward. Poster presentation at the UICC World Conference for Cancer Organisations, Dublin, Ireland, 17th-19th November.

WoSCAP: West of Scotland Cancer Awareness Project: Public Awareness Study
(Commissioned by West of Scotland Cancer Awareness Project, hosted by Argyll & Clyde Health Board, with funding from the New Opportunities Fund and NHS Health Scotland)

The West of Scotland Cancer Awareness Project was a multi-component early cancer detection campaign. It aimed to encourage 'at risk' populations living in the West of Scotland to present earlier to the NHS if they experienced signs and symptoms of oral cancer and colorectal cancer. ISM worked with the project from its inception, conducted both formative research to guide the development of the Campaign's communication strategy and evaluative research to monitor its impact.

A three-staged research design was employed, combining strategic research (S1), formative research (S2) and evaluative research (S3). S1 combined a literature review with exploratory research to guide strategic decisions relating to target audience, media selection, communication objectives, tone of voice etc, and supported the development of the agency brief; S2 employed qualitative pre-testing (or creative development research) techniques to help guide the development and execution of the creative strategy; and S3 used tracking survey methods to monitor response to individual campaign elements and the impact of the Campaign on awareness and knowledge of early detection and propensity to self-refer. NHS Health Scotland provided additional funding to incorporate a control and comparison group into the study design.

After extensive pretesting, the oral campaign was successfully launched in October 2003. Results from the first year follow-up of the oral cancer campaign were presented at the UICC world conference for cancer organisations in Dublin in November 2004. The campaign won Best Campaign in Inequalities in Public Health at the UK Association of Healthcare Communicators Conference 2004. The colorectal cancer campaign was launched in November 2004 by the Minister for Health.

ISM Staff: Douglas Eadie, Susan MacAskill, Martine Stead, Anne Marie MacKintosh and Laura McDermott (left 2008)

Eadie D, MacKintosh AM, MacAskill S and Brown A (2009). Development and evaluation of an early detection intervention for mouth cancer employing a mass media approach. British Journal of Cancer, 101: S73-S79, doi:10.1038/sj.bjc.6605395.

Eadie D and MacAskill S (2008). Symptom awareness and cancer prevention: Exploratory findings from an at-risk population. Health Education, 108(4): 332-345.

Eadie D and MacAskill S (2007). Consumer attitudes towards self-referral with early signs of cancer: Implications for symptom awareness campaigns. International Journal of Non-profit and Voluntary Sector Marketing, 12(4): 338-349.

Tackling Drugs in Disadvantaged Communities: An Investigation into the Role and Potential of Media Advocacy
(Commissioned by the Central Office of Information: Communications Division)

This qualitative study investigated the actual and potential contribution of media advocacy to drugs prevention efforts. It examined current practice among a range of local organisations in using the media, identifying both apparently effective uses of the media and problematic uses of the media; examined the factors which foster 'good' media advocacy; and assessed what support and guidance can be provided to encourage more focused and imaginative media advocacy for drugs prevention in the future.

The research adopted a community case study approach in two communities in the North of England. The research in each case study site comprised interviews with agencies with a drugs prevention remit about their approach to using the media, the 'targets' of these agencies' media work and an examination of actual media coverage.

The research is of benefit to agencies with an interest in drugs communication in that it: maps different local agencies' roles and positions in relation to using the media for drugs prevention; identifies ways to improve drugs agencies' effectiveness in use of the media (eg. training needs); informs the development of good practice guidelines and recommendations to enhance local use of the media to support and advance the national drugs strategy; and provides guidance on how media advocacy can contribute to community participation and action around drugs issues.

ISM Staff: Douglas Eadie, Martine Stead and Gerard Hastings

An Investigation into the Role and Potential of Media Advocacy as a Health Promotion Strategy
(Commissioned by the Health Education Authority, now Health Development Agency. In collaboration with Jenny Kitzinger and Lesley Henderson, formerly at the Media Research Unit, University of Glasgow)

Media advocacy is an approach to using the media as a public health lobbying tool which is increasingly being applied to efforts to influence health policy in the areas of tobacco and alcohol control, environmental health, the food industry, and poverty. This study, for the Health Education Authority, investigated the potential role and potential of media advocacy as a health promotion strategy for addressing health inequalities. The investigation included a substantial literature review of the effectiveness of mass media, media advocacy, agenda setting and policy change interventions, case studies of current and recent UK media advocacy interventions, and the development of a media advocacy evaluation framework.

ISM Staff: Martine Stead, Gerard Hastings and Douglas Eadie

Stead M, Hastings GB and Eadie D (2002). The challenge of evaluating complex interventions: A framework for evaluating media advocacy. Health Education Research Theory and Practice, 17(3): 351-364.

Developmental and Evaluative Research for the 'Foolsspeed' Campaign
(1998-2001) (Commissioned by the Department of the Environment, Transport and the Regions and the Scottish Road Safety Campaign)

This three-year programme of research was conducted to develop and evaluate the Scottish Road Safety Campaign's (SRSC) 'Foolsspeed' mass media campaign (1998-2003). Foolsspeed sought to reduce the use of inappropriate and excessive speed on Scotland's roads through a focused and structured publicity campaign which was explicitly shaped by the Theory of Planned Behaviour. Three television advertisements were run over a three-year period, each designed to address one of the TPB's three main predictors of behaviour: Attitude, Subjective Norms and Perceived Behavioural Control. A four-year longitudinal cohort study (550 drivers) examined the impact of the campaign on communications outcomes and on TPB constructs. A baseline questionnaire in 1998 took measures of Theory of Planned Behaviour determinants of driver attitudes, beliefs, speed choice and speeding behaviour. Follow-up questionnaires in 1999, 2000 and 2001 repeated the baseline questions and also took a series of communication measures, examining recall and awareness of the campaign, understanding and perceptions of the campaign's key messages, and response to the campaign in terms of identification, involvement and enjoyment. Overall, empirical support was found for the decision to use TPB as the theoretical underpinning of the advertising. The advertising was effective in triggering desired communications outcomes, and was associated with significant changes in attitudes and 'positive and negative affective beliefs' about speeding.

ISM Staff: Martine Stead, Anne Marie MacKintosh and Douglas Eadie

Publications: Stead M, MacKintosh AM, Tagg S and Eadie D (2002). Changing speeding behaviour in Scotland: An evaluation of the 'Foolsspeed' campaign. Edinburgh: Scottish Executive Social Research. Online

Stead M, Tagg S, MacKintosh AM and Eadie DR (2004). Development and evaluation of a mass media theory of planned behaviour intervention to reduce speeding. Health Education Research: Theory and Practice. Advance Access published on 15th June, 2004; doi: 10.1093/her/cyg093. Online

Local Drugs Prevention Partnerships and the Media

(Commissioned by the Home Office Central Drugs Prevention Unit)

This study examined the effectiveness of local Drugs Prevention Teams in generating appropriate media coverage of the second European Drugs Prevention Week. It adopted a case study design to identify and compare the approaches used by a number of different teams to build relationships with local journalists and other key partners, and to identify recommendations for good practice.

ISM Staff: Douglas Eadie

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